scholarly journals Sequential Dose-Dense Doxorubicin and Ifosfamide in Advanced Soft-Tissue Sarcoma Patients in an Out-Patient-Basis Schedule

Sarcoma ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-7
Author(s):  
G. F. G. Almeida ◽  
G. Castro ◽  
I. M. L. Snitcovsky ◽  
S. A. Siqueira ◽  
E. H. Akaishi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
High Frequency ◽  
Locally Advanced ◽  
Front Line ◽  
Advanced Soft Tissue Sarcoma ◽  
Grade 3 ◽  
Dose Dense ◽  
Sequential Strategy

Aims. This phase II study explored activity/safety of front-line dose-dense chemotherapy in high-grade STS (soft tissue sarcoma) patients and tested ezrin as prognostic factor.Patients and Methods. The protocol consisted of three cycles of doxorubicin (DOXO) 30 mg/m2on days 1–3 every 2 weeks, followed by three cycles of ifosfamide (IFO) 2.5 g/m2two hours a day on days 1–5 every 3 weeks, with GCSF support. Ezrin was assessed immunohistochemically.Results. Twenty patients, 13 metastatic and 7 locally advanced, were enrolled. Median age was 39 years (25–60). Median dose intensities were 42 mg/m2/week and 3.6 g/m2/week for DOXO and IFO, respectively. Grade 3/4 toxicities occurred in 18 patients. Response rate was 15% (3 of 20) by RECIST. Patients younger than 45 years with locally advanced disease and synovial histology presented longer survival. A trend towards longer survival was observed among ezrin-positive patients.Conclusions. This dose-dense schedule should not be routinely used due to its high frequency of toxic events; however, a sequential strategy with DOXO and IFO may benefit selected patients and should be further explored with lower doses. The role of ezrin as a prognostic marker should be confirmed in a larger group of patients.

scholarly journals A Phase II Study of Flavopiridol in Patients With Previously Untreated Advanced Soft Tissue Sarcoma

Sarcoma ◽  
2006 ◽  
Vol 2006 ◽  
pp. 1-7 ◽  
Author(s):  
Don G. Morris ◽  
Vivien H. C. Bramwell ◽  
Robert Turcotte ◽  
Alvaro T. Figueredo ◽  
Martin E. Blackstein ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Phase Ii ◽  
Locally Advanced ◽  
Soft Tissue Sarcomas ◽  
Dose Intensity ◽  
Advanced Soft Tissue Sarcoma ◽  
Kaplan Meier ◽  
Treatment Responses ◽  
Grade 3

Purpose. Flavopiridol is a potent cyclin-dependent kinase (CDK) inhibitor that has preclinical activity in many tumours. This synthetic flavonoid was tested in a phase II nonrandomized, nonblinded multicentre clinical trial to determine its activity and toxicity in patients with previously untreated metastatic or locally advanced soft tissue sarcoma.Methods. A total of 18 patients with histologically confirmed nonoperable soft tissue was treated with flavopiridol administered at a dose of 50 mg/m2IV over 1 hour daily×3days every 3 weeks.Results. Eighteen patients were accrued to the study over a period of 6 months. No objective responses were noted in the seventeen evaluable patients. Eight patients (47%) exhibited stable disease after 2 cycles (median duration of 4.3 months (range 1.4–6.9 months). Kaplan-Meier estimates for 3- and 6-month progression-free survivial rates were 44 percent and 22 percent, respectively. The only grade 3 toxicities were diarrhea (N=2), nausea (N=2), gastritis (N=1), and fatigue (N=1). Ninety-four percent of patients received≥90% of the planned dose intensity, during 55 treatment cycles.Conclusions. Flavopiridol was well tolerated at the dose and schedule used in this study, however, no objective treatment responses were seen and thus our results do not support further exploration of flavopiridol as a monotherapy at this dose and schedule in soft tissue sarcomas.

scholarly journals Symptom Burden, Survival and Palliative Care in Advanced Soft Tissue Sarcoma

Sarcoma ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Nicholas J. Gough ◽  
Clare Smith ◽  
Joy R. Ross ◽  
Julia Riley ◽  
Ian Judson
Keyword(s):  
Palliative Care ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Locally Advanced ◽  
Symptom Burden ◽  
Median Number ◽  
Best Supportive Care ◽  
Advanced Soft Tissue Sarcoma ◽  
Significant Symptom

Introduction. The symptom burden and role of palliative care (PC) in patients with advanced soft tissue sarcoma (STS) are not well defined.Methods. This study retrospectively reviewed both symptoms and PC involvement in patients known to an STS referral centre who died in one calendar year.Results. 81 patients met inclusion criteria of which 27% had locally advanced disease and 73% metastases at initial referral. The median number of symptoms was slowly progressive ranging from 2 (range 0–5) before first-line chemotherapy () to 3 (range 1–6) at the time of best supportive care (BSC) decision (). Pain and dyspnoea were the commonest symptoms. Median overall survival from BSC decision was 3.4 weeks. 88% had PC involvement (either hospital, community, or both) with median time from first PC referral to death of 16 (range 0–110) weeks.Conclusions. Patients with metastatic STS have a significant symptom burden which justifies early PC referral. Pain, including neuropathic pain, is a significant problem. Dyspnoea is common, progressive and appears to be undertreated. Time from BSC decision to death is short, and prospective studies are required to determine whether this is due to overtreatment or very rapid terminal disease progression.

Phase II Study of ET-743 in Advanced Soft Tissue Sarcomas: A European Organisation for the Research and Treatment of Cancer (EORTC) Soft Tissue and Bone Sarcoma Group Trial

2005 ◽  
Vol 23 (3) ◽  
pp. 576-584 ◽  
Author(s):  
A. Le Cesne ◽  
J.Y. Blay ◽  
I. Judson ◽  
A. Van Oosterom ◽  
J. Verweij ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Phase Ii ◽  
Median Duration ◽  
Phase Ii Study ◽  
Progression Free Survival ◽  
Advanced Soft Tissue Sarcoma ◽  
Free Survival ◽  
Grade 3 ◽  
Line Chemotherapy

Purpose This nonrandomized multicenter phase II study was performed to evaluate the activity and safety of Ecteinascidin (ET-743) administered at a dose of 1.5 mg/m2 as a 24-hour continuous infusion every 3 weeks in patients with pretreated advanced soft tissue sarcoma. Patients and Methods Patients with documented progressive advanced soft tissue sarcoma received ET-743 as second- or third-line chemotherapy. Antitumor activity was evaluated every 6 weeks until progression, excessive toxicity, or patient refusal. Results One hundred four patients from eight European institutions were included in the study (March 1999 to November 2000). A total of 410 cycles were administered in 99 assessable patients. Toxicity mainly involved reversible grade 3 to 4 asymptomatic elevation of transaminases in 40% of patients, and grade 3 to 4 neutropenia was observed in 52% of patients. There were eight partial responses (PR; objective regression rate, 8%), 45 no change (NC; > 6 months in 26% of patients), and 39 progressive disease. A progression arrest rate (PR + NC) of 56% was observed in leiomyosarcoma and 61% in synovialosarcoma. The median duration of the time to progression was 105 days, and the 6-month progression-free survival was 29%. The median duration of survival was 9.2 months. Conclusion ET-743 seems to be a promising active agent in advanced soft tissue sarcoma, with no cumulative toxicities. The 6-months progression-free survival observed in advanced soft tissue sarcoma compares favorably with those obtained with other active drugs tested in second-line chemotherapy in previous European Organisation for the Research and Treatment of Cancer trials. The median overall survival was unusually long in these heavily pretreated patients mainly due to the high number of patients who benefit from the drug in terms of tumor control.

scholarly journals A Phase II Nonrandomised Open-Label Study of Liposomal Daunorubicin (DaunoXome) in Advanced Soft Tissue Sarcoma

Sarcoma ◽  
2006 ◽  
Vol 2006 ◽  
pp. 1-5 ◽  
Author(s):  
Anne McTiernan ◽  
Jeremy Whelan ◽  
Michael Leahy ◽  
Penella J. Woll ◽  
Ian Judson
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Significant Activity ◽  
Open Label ◽  
Advanced Soft Tissue Sarcoma ◽  
Liposomal Daunorubicin ◽  
Open Label Study ◽  
Previously Treated ◽  
Grade 3 ◽  
Free Rate

Thirty four patients with advanced soft tissue sarcoma not previously treated with an anthracycline were treated with DaunoXome 100mg/m2 every 3 weeks. Thirty-three patients were evaluable for toxicity. Grade 3-4 neutropenia was seen in 20 patients (60.6%), complicated by febrile neutropenia in 2 (6.1%). Other grade 3 toxicities were rare. Among 32 patients assessable for response, one patient had a partial response, giving a response rate of 3.13% (95% confidence interval, 0.08–16.22%). Seven patients (21.9%) had stable disease, and 24 patients (75.0%) had disease progression. The median time to progression for all patients was 42 days (95% CI, 39–49) and the progression-free rate at 3 months was 12.5%. In conclusion, DaunoXome at this dose and schedule is well tolerated in patients with advanced soft tissue sarcoma, but is not associated with significant activity. Further studies at this dose and schedule cannot be recommended in this disease.

Management and outcome of patients with neo-adjuvant chemotherapy (CT) in locally advanced soft-tissue sarcoma (LASTS): The Gustave Roussy experience.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. 11580-11580
Author(s):  
Sarah Naomie Dumont ◽  
Elena Cojocaru ◽  
Matthieu Faron ◽  
Leila Haddag ◽  
Jean Francois Honart ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Locally Advanced ◽  
Advanced Soft Tissue Sarcoma ◽  
Neo Adjuvant Chemotherapy
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